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Individual
MITCHAEL GENE ESTRIDGE
Active
Individual
MITCHAEL GENE ESTRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24442
KY
208M00000X
Hospitalist Physician
Primary
24442
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110055339
RAILROAD MEDICARE PIN
KY
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64000912
—
KY
01
—
CB5773
RAILROAD MEDICARE GROUP
KY
Enumeration date
07/05/2006
Last updated
10/20/2011
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